PVCS/pacs. Good question

[PaladinX]

   hey everyone.  Here is my question.  What i dont understand is that I have read many times, that skipped heartbeats, pvcs, etc are very common.  Even the doctors on here said that any random person on a holter monitor would show PVCs.  So that means EVERYONE gets these usually.    Now its said some people feel them, and some people do not feel them.  No one has ever differentiated PVCS you feel vs ones you dont feel.  They say they are the same thing.  I wonder how true this is.
    So taking this all into consideration,  Why are there so many people here.  Why are people who feel PVCS recommended to get numerous tests when the average person on the street doesnt have to.  if everyone gets them,  Why is everyone here being recommended to get EKGS, holter monitors, echo's etc etc. Just because they feel them?    

  And what else can these sensations be besides PVCS, PACS etc.  For someone who is complaining of a weird sensation in their chest, a pause and then a strong heartbeat, What other condition can this be besides a benign condition?  I have never heard of any conditions that have the symptoms of pauses, skips and thuds. For example.  chest pain.  It could be from gas, muscles pulls, Or in the worst case scenario it can be angina .   But what is the worse case scenario for feeling skipped heartbeats?  MVP?  enlarged heart?   Are people with these heart conditions more prone to "feel" pvcs?  So then is there a difference between feeling and not feeling them?  

  I hope these questions dont sound absurd.  Im just trying to understand the jist of things

[Ivymay52]

Good question! I agree with everything you are saying PaladinX.  I would like to know as well!

[sb786]

I often wake up at night having an svt attack. I also get sinus tachy at night but at the time i am usually awake. SVT is when my heart jumps from about 60-100bpm to about 160-200 bpm in one single beat. It doesn't gradually get faster. If it takes a while to get faster its most probably sinus tach.

[kellebelle4]

Good Morning,

I think I have been having svt, usually I am prone to sinus tach. Anyway for 2 weeks I am waking every night tachy. My doc changed my med to toprol which has taken the edge off. My heart doesn't race so fast. My runs are shorter too. Yet still having the wake up calls.

Please explain the differenc between svt and sinus tachacharydia. How do you feel with these episodes? I will wear a Holter on Thursday to try to see whats up.

Thanks for your input.

[PaladinX]

   Heres one more question and more to the point.  If patient A has a feeling of a skipped beat.   A weird feeling in the chest, a pause and then a thud that happens occassionally.  They have a normal EKG reading, and normal holter monitor reading. (however the feelings didnt happen on the monitor). lets say they get an echocardiogram too and everything checks out normal.  So now patient A seems to have a structurally normal heart, but complains about a skipped beat sensation. Why is there a need for further testing.  What else can this sensation be? I guess thats my main question.  

[kitcurious]

People who do not feel them have no complaint and do not go to the doctor complaining of flutters they do not feel. If they are VERY frequent ectopics, like my son has, (or the tachycardia I had and never noticed) docs will find them upon general exam and order further tests. Anybody coming into an office complaining of chest flutters will wind up getting a slew of tests whether there is any evidence of them on exam or not.
They treat everyone c/o something like they are sick until the test results show otherwise.

[kitcurious]

If the patient continues to complain and wants further testing the next step may be an event monitor to try and capture exactly what is actually occurring during the complaint.

It's important to remember that a palpitation is any undue awareness of the heartbeat. It can be a strong beat, a fast beat, a slow beat, just that the patient is really aware of the beat. That is a palpitation. You can have PAC/PVCs/Tachycardia and no palpitations. I've seen ectopics of mine on the monitor after my stress test and didn't feel them.

If the patient wears an event monitor, and presses the button when having this sensation, the monitor will then capture what the feeling is, it even highlights the period directly before the button was pushed so it doesn't miss the moment. It may record benign PVCs, PACs, other rhythm disturbance, or it may be nothing.

[PaladinX]

  thats my question.  what are the other rhythm disturbances can it be besides a pvc or pac.  I have never heard of anything on this forum yet and i have read alot of posts.  Im not talking about palps where ur heart is pounding and racing.  Im talking specifically about the skipped beat sensation the pause and thud. Let say they capture it on the monitor.  What are the possiblities of what it could be besides PVC's and PACS. The only thing im aware of an enlargement or MVP.  but these are diagnosed on an echocardiogram.  


  So tell me what can the event monitor say about these that an echo cannot besides saying its a pvc or pac

[anacyde]

Hmm.

Sometimes palpitations can mean something, such as an enlarged heart, a PFO or a valve problem.  Typically they're just benign.  Either way they often feel the same.

I've personally had the experience of being on a monitor and viewing my palpitations.  A PAC that I feel versus a PAC that I did not feel, there was absolutely no visual difference on the screen.  I was quite amazed to see blips up there when I felt nothing, yet they were quite clearly visible as a PAC.

As far as worst case scenario, palpitations in the general sense can be anything from the benign bits everyone has to a more serious arrhythmia like vtach.  Again personally, I have PACs, PVCs and SVT.  While similar in some respects, they are also distinctly different for me and fairly easy to identify.  The only trouble I sometimes have is SVT versus sinus tachycardia.  Chances are if you're feeling the same thing, or a close variant of it that only lasts a blip or two, it's the same PAC/PVC stuff.  If it becomes rapid and erratic, chances are it's something else and then needs evaluated.

I hope that helped a little, from a fellow wonderer ;)